- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,462.10 / $17,661.80 / $31,079.70
| Facility | | $10,462.10 | $17,661.80 | $31,079.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,154.96 / $20,723.47 / $34,364.65
| Facility | | $14,154.96 | $20,723.47 | $34,364.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,516.94 / $16,279.87 / $22,479.58
| Facility | | $9,516.94 | $16,279.87 | $22,479.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,582.15 / $26,582.15 / $31,196.41
| Facility | | $26,582.15 | $26,582.15 | $31,196.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $15,392.11 / $21,985.87
| Facility | | $1,787.00 | $15,392.11 | $21,985.87 |